LUCID


This Monday’s Poem of the Week highlights the Faustian bargain of our most potent opioid drugs – assuaging pain at the price of obliterating consciousness and memory.

LUCID

You turn the knob of the old radio

looking for a signal in the static

they say is the noise of the stars.

Move too quickly and you find

only a whine whistle

gone as soon as heard.

Titrate me, nurse,

between pain and drowsiness

that I might hear myself think.

Jonathan H. Marks

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Thanksgiving and Friendship


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What better time is there to be grateful for old friends than during Thanksgiving? I recently had the pleasant experience of an unexpected phone call from one of my oldest friends. We had been together since the sixth grade, all the way through college, when our paths diverged. I moved away pursuing a new career in medicine, while he stayed in Chicago, eventually to take over his father’s business. Except for an annual card at Christmas from him, and a newsy holiday letter from me, we hadn’t connected with each other in decades.  I’m not on Facebook or social media sites, but thanks to my profession, anyone can l easily look up my office number, which is what he did. We exchanged home numbers, and subsequently talked at length about the events of our past lives. We reminisced about things we did in our younger days, and what happened to the friends we had in common.  I learned that after he eventually sold his father’s business, he started a new career working for the State. He also became a model, went to acting school, and had steady gigs in local productions. He sounded grounded, happy, and brought back the memories of our shared good times. I didn’t ask why my friend had chosen this particular time to reach out to me in all the years since we have been apart, but I suspect that our present times of Covid and enforced isolation may consciously or unconsciously have played a role in his picking up the phone.Research has shown that psychological distress often causes nostalgia. People tend to experience this sentimental longing when life feels uncertain or meaningless. Psychologists have found that nostalgia increases self-esteem and confidence, making us feel more connected and optimistic. While we may experience nostalgia for any period of our life, we most desire to reconnect with our late adolescence and early adulthood – the period when we most develop our own sense of identity.Regardless of the motivation behind his call, I found myself smiling for days as I replayed our conversations in my head. Why do so many of us allow these old connections to atrophy? Often it is precipitated by a physical separation. We become enmeshed in trying to create a new space and a new life in our current place, and what is out of our sight soon becomes out of mind. It takes will and energy to maintain friendships, and sadly, many of us do not put in the time and effort it takes to keep these relationships alive. It isn’t until we are faced with some crises in our lives that we suddenly face the realization that there are very few people around us who not only know us, but also care. Our contact list may contain hundreds of names of those with whom we may have shared some social exchange, but few, if any who we feel really know us, or have a real interest in sharing the triumphs and tribulations of our lives.Perhaps this is the most significant part of the Thanksgiving holiday, rather than the feasting and football games on TV – the sharing of friendship, the reconnection of family bonds, and recognition of how fortunate we are in having someone with whom to celebrate. If you haven’t reconnected with an old friend or family member, can you think of a better time to reach out and call? Happy Thanksgiving to you all!

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And A Helmet


We’re approaching (can you believe it!) Thanksgiving this Thursday, a time traditionally filled with an abundance of food, family, and of course, football. My gratitude to Dave for allowing me to post the following poem from his wonderful collection. Please visit his site at http://www.phrenopolis.com to see all his other wonderful treasures.

And a HelmetLife should have an instant replay
Just like football on TV
So many moments through the day
Would benefit from scrutiny And then there are the pits and snags
When rulings on the field are skewed
For these we need a challenge flag
A way to get things booth reviewed Commentary’s there in spades
From seven billion panelists
But entirely too much play-by-play
And not enough analysis A playbook and an overhead cam
Would help my plans enormously
A halftime break with a marching band
And a deeper bench, with a second-string me

Permanent link to this entry: http://www.phrenopolis.com/poem/index.php?p=858

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Poem by Nikki Giovanni


Welcome back to Poetry Monday. For those of us who are still in search of the meaning in our lives, this poem speaks volumes.

in youth our ignorance gives us courage

with age our courage gives us hope

with hope we learn that man is more

than the sum of what he does

we also are what we wish we did

and age teaches us

that even that doesn’t matter.

Posted in America, Books and Literature, Hope, Poetry, Thoughts & Musings, Time | Tagged , | 5 Comments

Application For Permission To Date My Daughter


For those of you who have daughters of the age where dating is a current or future possibility, this piece from the Archives is for you.

APPLICATION FOR PERMISSION TO DATE MY DAUGHTER

~ This application will be Incomplete and rejected unless accompanied by a complete financial statement, lineage history and current medical report from a doctor of my choosing.                 

DATE OF BIRTH________________ NAME:___________

HEIGHT:                                                        WEIGHT:                                               IQ:                                                                                    GPA:_______

SOCIAL SECURITY NO:                                                                                    .                        DL NO:

BOY SCOUT RANK:                                           

SUNDAY SCHOOL ATTENDED:________________

Do you have one MALE and one FEMALE parent?__________If “NO” explain on back of this page

Number of years parents married                    Any brothers or sisters7                  Are they normal?_____________

Do you own or have access to: a van _________ A truck with oversized tires                                

A waterbed_________ Do you have an earring, nose ring or belly ring?_____________

A tattoo?___________

(if yes to any of these, discontinue application and leave premises immediately)

In 50 words or less1 what does the word LATE mean to you? _________________________________________

In 50 words or less what does “Don’t touch my daughter” mean to you?

In 50 words or less, what does the word “NO” mean to you 7 ___________________________________________

In 50 words or less, give your definition of Real Pain”: _________________________________________________

Church you attend:                                                                                                    

How often do you attend: S, M, T, W, Th, F,

When would be the best time to interview your mother, father and minister?________________________________ Please fill in the blanks:

A    If I were shot, the last place on my body I would want wounded would be my ______________

B    If I were beaten, the last bone I would want broken would be my_________________________

C    A Woman’s place is in the _________________________________________________________

D    The one thing I hope this application doesn’t ask is________________________________________

E   When I meet a girl  the first thing I always notice is her_____________________________________

F  What do you want to be if you grow up____________________________________________

I swear that all the above information is correct to the best of my knowledge under penalty of death, bodily harm dismemberment, torture or natural disaster.

Signature of Applicant____________________________________

Signature of  Father                                                                                     Signature of Mother

Signature of Minister_____________________________________

Signature of State Representative

Thank you for your interest. Please allow 4-6 weeks for processing. You will be contacted in writing if

approved. If denied, please never apply again. Don’t  call  me!  I’ll call you!

Posted in America, Children, Dating, Family, Humor, Relatioships, Thoughts & Musings | 3 Comments

Gone Today


For the upcoming months, I’m delighted to intermittently share with you the poetry of a creative writer and friend, all of whose work can be found on his website, http://www.phrenopolis.com

Gone Today

O, fickle firmament
Your vexing impermanence
Has somehow deleted my keys
Curse my stupidity
Belief in solidity
Lies of the clouds and the breeze Physics is wedlock
On marshmallow bedrock
When things cease to be without cause
Confidence shattered
Conservation of matter
Those guidelines we all thought were laws In objects, capacity
For existence tenacity
Is assumed as a point of respect
But this impropriety
Gorges anxiety
Over what things will disappear next Oh wait! Here they are
That’s rather bizarre
I checked there before
Three times, maybe more
Yet suddenly, these
Incorporeal keys
Have revised their decision to be
Should my trust be restored
This infraction ignored
Or are you just screwing with me?

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A Good Plan for Thanksgiving


This sounds like a good plan!

An elderly man in Phoenix calls his son in New York and says, “I hate to
ruin your day, but I have to tell you that your mother and I are
divorcing; forty-five years of misery is enough. “

“Pop, what are you talking about?” the son screams.

“We can’t stand the sight of each other any longer,” the old man says.

“We’re sick of each other, and I’m sick of talking about this, so you call
your sister in Chicago and tell her.”

Frantic, the son calls his sister, who explodes on the phone. “Like heck
they’re getting divorced,” she shouts, “I’ll take care of this.”

She calls Phoenix immediately, and screams at the old man, “You are NOT
getting divorced. Don’t do a single thing until I get there.  I’m calling
my brother back, and we’ll both be there tomorrow. Until then, don’t do a
thing, DO YOU HEAR ME?” and hangs up.

The old man hangs up his phone and turns to his wife. “Okay,” he says,
“they’re coming for Thanksgiving and paying their own fares. Now what do
we do for Christmas?”

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Paris Poem


It’s Monday, so it must be time for another Poem of the Week. Enjoy a little travel nostalgia.

paris poem

sitting in a café pretending I’m Hemingway

sipping and stretching out my café au lait,

acting like I’m scribbling away

about bullfights and war and Beaujolais

when really I haven’t got much to say

as I perpetrate my male gaze

on the beauty winding through the Parisian maze

trailing French vowels like a perfume haze

that leaves me grinning, dazed and crazy

to rendezvous with a certain French lady

waiting behind her four-digit code

at the top of an art nouveau abode

tucked on a dog-shit-peppered road

where I once smeared a turd and showed

up embarrassed and smelling commode-

like, most incommodious. 

an unpleasant memory best laid away

as I’m pretending I’m Hemingway,

sneaking some bourbon in my café au lait

wondering how to pronounce Beaujolais

and forgetting whatever I meant to say.

Peter Ferenczi

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Sure signs


We’re finally getting rain in Southern California, another sign that fall is here, winter is to follow. Here is another poem from Ted Kooser, one of my favorites, for this Monday’s Poem of the Week.

So many crickets tonight –
like strings of sleigh bells!
“A long hard winter ahead
for sure” my neighbor says ,
reeling a cobweb onto
a broom in his garden .
“Crickets and cobwebs “ he says,
“sure signs. In seventy years
(he looks over his glasses
to see if I am still there)
you get to know a thing or two.”

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Advice For Those Who Wish To Become Physicians


Advice for Those Who Wish To Become Physicians

When I was in undergraduate school, I wanted to be an oceanographer. I was fortunate enough to be accepted to three top ranked programs. Unfortunately, they were all private schools, and even with partial financial aid, my newly arrived immigrant parents couldn’t pay the difference. Like many others, I applied to banks for private loans. As I had no collateral to offer, and there was no guarantee of a job at the end of my degree, I was turned down for the loan. One bank officer, seeing my science heavy transcript, suggested that if I chose to apply to medical school instead, they would be happy to give me the financial aid I sought. Lacking other better options at the time, I followed his advice, was accepted, and have remained grateful since to have the opportunity to provide care for people in need. My new career choice occurred a little more than fifty years ago, and medicine has changed considerably since then. Yet, if you were to ask me today, “would you do it again?” the answer would be a resounding yes.

There are not a lot of opportunities in life that offer the chance to help someone other than yourself, that remain constantly challenging and evolving, that come with economic and relative job security, and that offer an extremely wide variety of options in an ever expanding science. Medicine has allowed me to meet and get to know people with remarkable stories of life that have been more fascinating than many novels, and inspiring in ways I never expected. Despite all the roadblocks being erected between physicians and their patients, these opportunities continue to exist today, and remain, at least for me, the greatest reward of my profession.

Despite the negative changes driven by the corporate and governmental takeover of health care, more students than ever are applying to medical school, and even more are needed. The biggest challenge for those desiring to be in this field is getting accepted. The best advice I can offer is to do your best to get into the best college/university that you can, then work as hard as you can to get the best grades possible. Sadly, even when you achieve this goal, there is still not an absolute guarantee that you will be accepted. If this is something you truly desire, don’t give up if you’re turned down. Take an extra year in a master’s program and/or research, and reapply again. I know a number of highly qualified applicants initially turned down who were accepted the following year. Know also that there are some significant differences between schools offering an MD as opposed to a DO degree. The later, also known as osteopathic schools, are all private institutions, typically with equally or more expensive tuitions, whose graduates are also called doctors, and who today can be licensed in all US States. Aside from a greater selectivity in the admission process amongst entering applicants, the first two years of school are similar in both types of institutions. DO schools typically are not actively involved in basic science research, so if you are considering an academic career, these are definitely not the schools for you. The biggest difference occurs in the last two years, the so-called clinical years. DO schools typically do not have a university hospital (where students train with full time clinical staff who in turn, teach, provide direct patient care, as well as conduct research.) affiliated with them. Rather, students in DO programs have to find community preceptors to obtain the required clinical training. These are usually individuals in private practice, who without direct compensation (or oversight) from the school are willing to have student follow them around for a month. While some of the physicians who provide these services are competent and are good teachers, others look upon students as a cheap source of labor, and haven’t always kept up with the advances in their own fields. Students at DO schools also have to travel at their own expense, not infrequently out of state, to find required clerkships. Having served as faculty in both an MD and DO school, I have certainly had DO students who have turned out to be excellent doctors, in some ways, better than their MD counterparts. The uniformity of learning experience, however, leaves many DO students at a disadvantage, which becomes apparent to them when they discover their inability to be accepted into more competitive medical specialty training programs such as ophthalmology or orthopedics.

If you are still reading this piece, what follows are some life choices I would advocate for those going to medical school. To say that med school is strenuous is not an exaggeration. It’s hard enough to do by yourself, but even more challenging if you are a newlywed. By the time I graduated, half my class was married. When I went back for my 25th class reunion, only four of those couples were still together. It can be done, but…

As I said, school is not only difficult, but at times, traumatic. Death, dying, abandonment, failure are tough topics that many of us had never faced before. The advice here is, don’t try to do it alone. Whether it’s a friend, family member, a faculty mentor, you minister, talk to someone – don’t keep your feelings bottled up inside. Depression, anxiety, suicide are real issues in school magnified by the pressures of what you see and do. I almost quit medical school after my first year, and it was only through the intervention of an understanding faculty mentor that I made it through.

As students going through our clinical rotations, we often change our minds in which field we wish to practice our art. Our choices are not infrequently influenced by a charismatic practitioner we are exposed to, leading us to think, “This is what I want to do for the rest of my life!” Before you make a final decision, learn us much as you can about the field of your interest by not only talking to a number of different doctors who are doing what you desire  for yourself, but ideally, spending some time with them to see how their career choices have impacted their lives. Emergency medicine is a popular specialty for both sexes these days, as it allows you to work fixed hours, limit your schedule during the childbearing years, and offering relative geographic portability in the case of two career couples. The down side comes when you get into your fifties and sixties, and your body has difficulty dealing with the shift hours and time changes the specialty requires. And if family life and being involved with your children is your first priority, you might want to rethink interventional cardiology as your medical specialty.

Of those physicians currently in practice, 52% are now employees. While many new graduates find this not only acceptable but even desirable, as they don’t have to learn and deal with the challenges of running a medical practice, it also places them in a role where the hours they work, the time when they take a vacation, and the number of patients they have to see in a day is decided for them. It’s difficult to establish rapport with a person when you are limited to a 7-10 minute window for each visit. It is also hard to show compassion to someone who needs a lot more of your time when your assistant is mandated to turn over the room every 10 minutes. The only way you have any control over your own life is to be your own boss. Think about that when you chose the model in which you practice.

While most doctors are still well compensated for their time compared to other fields, that amount is decreasing each year. In 2022, Medicare is cutting what they pay us by 6%, with commercial payers happily matching those reductions. You can expect this trend to continue for a long time. At the same time, many new graduates are carrying student loans in excess of $300,000. Sadly, this results in people making career choices based on how much they can make, rather than on what they actually would like to do. Part of the problem is that with the deferred gratification medical school requires, too many new graduates lock themselves into expensive lifestyles by purchasing expensive houses and cars and taking luxury vacations. They feel they are “owed” this for putting all the years and effort into their training. The sad result of adding to their financial commitments is the marked narrowing of choices with respect to the way they practice. Knowing that as soon as their financial production falls of they can lose it all, they find themselves on rapidly accelerating treadmill of work. They can’t afford to slow down, to “smell the roses”, to live their lives as their own conscience and the needs of their family might require. If you keep your expenditures significantly below your income, you can weather downturns without anxiety, and make important life choices without money being the key decider.

We need more good physicians, ones whose bottom line will be the welfare of their patients, not their own.  I sincerely hope you will be one of them.

Posted in America, Ethics, Health and wellness, Medicine, Relatioships, School, Thoughts & Musings | Leave a comment